How painful is induced labor?

Women will not feel very painful during the induced labor, but after the anesthesia, there will be abnormal pain. At this time, they need to endure the pain. If the pain is too severe, they can take some painkillers, but this kind of medicine should not be taken in excess. In addition, induced labor in late pregnancy will be more dangerous and will have more adverse reactions.

1. Absolute contraindications to induction of labor in late pregnancy and contraindications to vaginal delivery

① Placenta previa (especially central placenta previa) or vasa previa. ②Umbilical cord prolapse. ③ Relative or absolute cephalopelvic disproportion or malposition of the fetus, making vaginal delivery impossible. ④The fetus cannot tolerate vaginal delivery. ⑤ Pregnant women who cannot tolerate the burden of delivery: such as those with heart failure, severe liver and kidney diseases, severe pregnancy-induced hypertension combined with organ damage, etc. ⑥ History of uterine surgery: including classic uterine incision, uterine plastic surgery or myoma removal into the uterine cavity, and history of uterine perforation. ⑦ Soft birth canal abnormalities: including invasive cervical cancer, cervical edema, birth canal obstruction, and certain reproductive tract infections (such as active herpes infection, HPV infection, etc.).

2. Relative contraindications to induction of labor for certain obstetric complications and comorbidities

① History of cesarean section with transverse incision of the lower uterine segment. ② Breech presentation. ③Excessive amniotic fluid. ④The presenting part has not yet entered the pelvis. ⑤Twin and multiple pregnancy. ⑥ Multiparous women. ⑦ Pregnant women have heart disease or severe hypertension.

1. Stripping of membranes to induce labor

The fetal membrane is separated from the lower part of the uterus by hand. It can only be used when there is no vaginal infection and the fetal membrane is intact. Induction of labor by stripping of membranes can cause the release of a large amount of prostaglandins, which increases the incidence of spontaneous labor by 100%. However, it may cause complications such as infection, neglected bleeding from placenta previa or low-lying placenta, and accidental rupture of membranes, and is rarely used nowadays.

2. Mechanical dilator

There are many types, including water bags, Foleys tubes, kelp strips, seaweed sticks, etc. They also need to be used when there is no vaginal infection and the fetal membranes are intact. It promotes the softening and maturation of the cervix by mechanically stimulating the cervical canal and promoting the synthesis and release of local endogenous prostaglandins in the cervix. Its disadvantages are the possibility of potential infection, premature rupture of membranes, and cervical laceration, which limits its application.

3. Rupture of membranes and induction of labor

Artificial rupture of membranes stimulates uterine contractions and the use of oxytocin can shorten the labor process. Its advantages are high success rate and the ability to observe the characteristics of amniotic fluid. The success rate can reach 88% in pregnant women with mature cervixes. The disadvantage is that it may cause umbilical cord prolapse or compression, maternal and fetal infection, rupture of vasa previa and fetal injury. The rupture of membranes before labor should have a negative swab result

The procedure can only be performed after it is proven that there is no vaginal infection or fungal or Trichomonas infection. Before rupturing the membranes, check whether the umbilical cord is exposed and listen to the fetal heart rate. The membranes should be ruptured during the interval between uterine contractions to avoid rapid outflow of amniotic fluid that may cause umbilical cord prolapse or placental abruption. After rupturing the membranes, listen to the fetal heart rate again and observe the characteristics of the amniotic fluid and changes in the fetal heart rate. If the amniotic fluid is meconium-stained and the fetal heart rate is obviously abnormal, and delivery cannot be completed in a short period of time, a cesarean section should be performed promptly.